Objective:Splanchnic venous thrombosis (SVT) conceptually embraces thrombosis in portal, hepatic, splenic and mesenteric venous system thrombosis. Risk factors of SVT may be classified as abdominal disorders, underlying myeloproliferative neoplasms, inherited thrombophilic syndromes and autoimmune disorders. The aim of our study is to evaluate the risk factors for SVT and their relations with localization of involvement and anticoagulation during the acute period and relation with major bleeding.

Methods: All patients in whom “portal vein thrombosis” or “splenic venous thrombosis” in their radiologic evaluation report were included over a 5-year period.

Results: Of the 96 patients, 87 had identifiable risk factor for SVT (90.6%). Major risk factor was cirrhosis (60 patients, 62.5%). Other risk factors included thrombophilic conditions (12 patients, 12.6%) 6 patients had myeloproliferative disorder (6.3%) and most interestingly, 24 had occult malignancy for which, SVT was the presenting factor(25%). Within the whole group, 51 patients (53.1%) have received anticoagulant treatment. Within the whole group, 30 patients developed major bleeding (31.3%) and 20 if these patients did not receive anticoagulation. 25 of the patients with cirrhosis had bleeding and 18 of them did not receive anticoagulation.

Conclusion: Almost all patients with SVT had an identifiable risk factor, follow-up and further treatments should be based on this risk factor. SVT may be the presenting finding of occult malignancies and should be sought in every patient with SVT. Anticoagulation during the initial acute period should not be withheld even in patients with CLD with a concern for major bleeding.